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General NPI Number Information
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NPI Number | 1558698167
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Entity Type | Individual
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Provider Name | DALLIN ORIN FARAR PA
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Gender | Male
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 2377 S 22ND DR
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City | YUMA
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State | AZ
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Zip | 85364-8865
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Country | US
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Telephone | 928-343-0488
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Fax | 928-782-0401
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Provider Business Mailing Address
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Address Line | 2270 S RIDGEVIEW DR STE 300
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City | YUMA
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State | AZ
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Zip | 85364-8866
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Country | US
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Telephone | 928-329-4771
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Fax | 928-329-4886
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 4527
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License Number State | AZ
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